Impact of Systems of Care on School Functioning

Macro Presentation April 2007

System of Care Communities of the Comprehensive Community Mental Health Services for Children and Their

Families Program

Funded Communities

1993–1994 221997–1998 231999–2000 222002–2004 292005–2006 30

Date Number

Baltimore, MD

Passamaquoddy Tribe, ME

AlbanyCounty,

NY

Delaware (statewide)

Southeastern Connecticut

Worcester, MA

Westchester County, NY

Bismarck, Fargo, & Minot, ND

Northern Arapaho Tribe, WY

Wisconsin(6 counties)Sacred Child Project,

ND

Willmar, MN

Nebraska(22 counties)

Birmingham,AL

HillsboroughCounty, FL

West Palm Beach, FL

ClarkCounty, NV

Navajo Nation

Las Cruces, NM

King County, WA

Clark County,WA

Clackamas County, OR

Lane County, OR

Wai'anae & Leeward, HI

Napa & Sonoma Counties, CA

California 5 (Riverside, San Mateo, Santa Cruz, Solano, & Ventura Counties)

Santa Barbara County, CA

Sedgwick County, KS

Southeastern Kansas

San Diego County, CA

Eastern Kentucky

St. CharlesCounty, MO

RuralFrontier, UT

TravisCounty, TX

Sault Ste. Marie Tribe, MI

Detroit,MI

Allegheny County 1, PA

Southern Consortium& Stark County, OH

Pima County, AZ

Yukon Kuskokwim

Delta Region, AK

Contra Costa County, CA

United Indian Health Service, CA

Denver area, CO

Gwinnett & Rockdale Counties,

GA

Lake County, IN

Nashville, TN

Guam

Puerto Rico

Northern Kentucky

Fairbanks Native Association, AK

ChoctawNation, OK

Southwest Missouri

SoutheasternLouisiana

Colorado (4 counties)

El Paso County, TX

Oklahoma(5 counties)

Ft. Worth, TX

San Francisco, CA

Sacramento County, CA

Glenn County, CA

Idaho

Urban Trails,Oakland, CA

Monterey, CA

Montana &Crow

Nation

Mid-ColumbiaRegion

(4 counties), OR

Los Angeles County, CA

Butte County, CA

Placer County, CA

Blackfeet Tribe, MT

Wyoming(statewide)

Minnesota(4 counties)

Kalamazoo County, MI

Ingham County, MI

Beaver County, PAAllegheny County 2, PA

MonroeCounty, NY

MississippiRiver Delta

area, AR

HarrisCounty, TX

Honolulu, HI

Maury County, TN

Mecklenburg County, NC

SarasotaCounty, FL Broward County, FL

Lyons, Riverside,

& Proviso, IL

Chicago, IL

CuyahogaCounty, OH

Charleston, WV

Greenwood, SC

North Carolina (11 counties)

Burlington County, NJ

New Hampshire (3 regions)

Montgomery County, MD

Rhode Island 3 (statewide)

Worcester County, MAMaine (3 counties)

Vermont 2(statewide) Rhode Island 2 (statewide)

North Carolina(11 counties)

Maine (4 counties)

Vermont 1(statewide)

Edgecombe, Nash, & Pitt Counties, NC

Alexandria,VA

Rhode Island 1 (statewide)

Charleston, SC

South Philadelphia, PA

Mott Haven, NY

South Carolina (3 counties & Catawba Nation)

Washington, DC

Bridgeport, CT

New York, NYErie County,

NY

CaliforniaRural Indian

Health Board,Inc., CA

Pascua YaquiTribe, AZ

LancasterCounty, NE

St. Louis,MO

St. Joseph, MO

MarionCounty, IN

Minnesota(6 counties)

OglallaSioux

Tribe, SD

YanktonSioux

Tribe, SD

McHenry County, IL

Iowa(10 counties)

Milwaukee, WI

HindsCounty, MS

Mississippi(3 counties)

Multnomah County, OR

CMHI: Community Sites with School-based Programs/Components 32 funded communities to date with a school-based

program/component Across Phases I – V PBIS (7), school-based wraparound/care coordination

(16), school-based counseling/therapy (7) are the most common programs/components

System of Care Communities with a School-based Focus/Program

Funded Communities

1993–1994 51997–1998 111999–2000 72002–2004 42005–2006 5

Date Number

Baltimore, MD

Passamaquoddy Tribe, ME

Delaware (statewide)

Nebraska(22 counties)

Birmingham,AL

HillsboroughCounty, FL

West Palm Beach, FL

Clark County, WA

Sedgwick County, KS

San Diego County, CA

Eastern Kentucky

RuralFrontier, UT

Southern Consortium& Stark County, OH

Denver area, CONorthern Kentucky

Ft. Worth, TX

KalamazooCounty, MI

MississippiRiver Delta

area, AR

Lyons, Riverside,& Proviso, IL

Chicago, IL

Greenwood, SC

Montgomery County, MD

Worcester County, MA

Rhode Island 3 (statewide)

North Carolina(11 counties)

SouthPhiladelphia, PA

Bridgeport, CT

LancasterCounty, NE

St. Joseph, MO

HindsCounty, MS

Rhode Island 2 (statewide)

Marion County, IN

CMHI: Community Sites with School-based Programs/Components, cont’d

Phase Communities

I

(5 sites)

East Baltimore, MarylandStark County, Ohio, and Southeastern Ohio (10 counties)

Sedgwick County, KansasLyons, Riverside, and Proviso Townships, IllinoisSouth Philadelphia, Pennsylvania

II

(11 sites)

Jefferson County, AlabamaSan Diego County, CaliforniaPassamaquoddy Tribe, Indian Township, MaineCentral Nebraska (22 counties)Blue Ridge, Cleveland, Guilford, & Sandhills, NC

Hillsborough County, FloridaEastern Kentucky (3 Appalachian regions)Lancaster County, Nebraska (Lincoln, NE)Rhode IslandRural Utah (10 counties)Clark County, Washington

III

(7 sites)

Denver, Jefferson, Clear Creek, and Gilpin Counties, CoDelawareWest Palm Beach, Florida

Montgomery County, MarylandHinds County, MississippiGreenwood, South CarolinaIndianapolis, IN

IV

(4 sites)

Chicago, ILBridgeport, Connecticut

Fort Worth, TXKentucky

V

(5 sites)

Mississippi River Delta, ARBoston, Massachusetts

Kalamazoo, MI Rhode IslandMissouri

CMHI: Highlights from the Phase V Programs

Site Name Brief Program Description

Mississippi River Delta, AR

Will offer comprehensive school-based services through the evidence-based Positive Behavioral Interventions and Supports program. Will integrate Cognitive-Behavioral Therapy, Multisystemic Therapy, and The Incredible Years. Will provide a full array of mental health services and supports.

Boston, Massachusetts The use of specific EBPs for the juvenile justice population and Positive Behavioral Interventions and Supports (PBIS) was discussed. The site will also provide supports for families with youths displaying substance abuse issues while they are awaiting co-occurring substance abuse therapy. Crisis options for the youths with the highest intensive needs were discussed.

Kalamazoo, MI Plan to work with the Department of Education to adapt Positive Behavioral Interventions and supports for special need schools. Will provide cross training opportunities for providers and families, community members in EBP. All child serving mental health providers are required to participate in 24 hours of annual training. Training will focus on implementation of Positive Behavioral Interventions and Support (PBIS), Parent Management Training (PMT), Integrated Co-Occurring Treatment and Direct Supervision. Partnering with the Department of Community Health to bring PMT to Michigan.

Rhode Island The local evaluation will ask whether the initiative improves outcomes for children with SED and their families and under which conditions the outcomes are achieved. The evaluation provides for natural comparison groups of children with SED who attend the following types of schools--(1)those that neither implement PBIS nor SOC/RICASSP, and (2) those that implement PBIS only, and (3) those that implement both PBIS and SOC/RICASSP. The evaluation will allow for comparison across children who attend these different programs as well as an assessment of school-level outcomes in each of these three types of schools.

Missouri This community provides the full array of basic services and has a history of providing Wraparound. Other practices may yet be identified. This community has school based services for day treatment, counseling, & case management.

National Evaluation: Examples of School-related Indicators

Study Component School-related Indicators

Services Experience Study Agencies involved in service provision Location of service provision Type of service provided

Descriptive Study Referral source History of receipt of school-based services

Child & Family Outcome Study School achievement Special education status Grade level, attendance IEP status Suspension & expulsion School functioning (CAFAS) School-related strengths (BERS)

Setting the stage….

Educational Characteristics of Students Served in Systems

of Care: A National Perspective

School performance in past 6 months (percentages)

Enrollment(N = 6127)

6 months(N = 3716)

12 months(N = 2841)

18 months(N = 1949)

24 months(N = 1324)

Failing half or more classes

24 18 16 14 13

D Grades 14 12 12 12 12

C Grades 27 30 32 32 32

A / B Grades 32 38 39 40 42

Missing / Unknown

3 2 1 2 1

Absences during previous 6 months (percentages)

Enrollment(N = 5123)

6 months(N = 2926)

12 months(N = 2193)

18 months(N = 1452)

24 months(N = 1003)

2 or more days/week

23 17 15 15 15

2 or more days/month

29 28 27 28 25

1 day or less / month

48 55 57 57 60

Suspensions during past 6 months (percentages)

Enrollment(N = 6321)

6 months(N = 3819)

12 months(N = 2910)

18 months(N = 1991)

24 months(N = 1350)

Yes 44.6 35.5 33.7 29.5 30.9

No 55.4 64.5 66.3 70.5 69.1

Expulsions during past 6 months (percentages)

Enrollment(N = 6321)

6 months(N = 3819)

12 months(N = 2910)

18 months(N = 1991)

24 months(N = 1350)

No 92.3 94.7 95.7 95.7 95.9

Yes 7.7 5.3 4.3 4.3 4.1